Full Name or Nickname         

Email Address                         

Phone Number                         

Location/Address of Equine 

In What City                             

In Which State                          Choose a State Alabama Alaska Arizona Arkansas California Colorado Connecticut D.C. Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Concern                                    Select Concern Physical Abuse Abandonment Emaciated/Underweight Overweight Slaughter Auction Inadequate Environment No/Little Food, Water, and/or Shelter General Concern/Question

Explain Situation In Detail      

Identifying Marks:                     If you are unsure about the identifying markings, please click here.

Face                                          Select Marking Bald Blaze Snip Snip/Star Snip/Strip Star Stripe None

Body(Describe Unique Marking)                             

Front Right     Front Right Leg Coronet Half Cannon Half Pastern Sock Stocking None

Front Left     Front Left Leg Coronet Half Cannon Half Pastern Sock Stocking None

Rear Right    Rear Right Leg Coronet Half Cannon Half Pastern Sock Stocking None

Rear Left     Rear Left Leg Coronet Half Cannon Half Pastern Sock Stocking None

Tattoos or Chestnuts/Ergots (Describe Location)   

Henneke Body Condition Score                                 Choose a Score 1 2 3 4 5 6 7 8 9        Please Use Henneke Score Card.

If there is more than 1 equine, please give identifying marks of all equines in the space below.  Please number each horse.

Any Other Concerns, Questions, or Information

May We Call You?             Yes                   No